The association between environmental tobacco smoke exposure and childhood respiratory disease: a review

ABSTRACT

Introduction: Childhood respiratory illness is a major cause of morbidity and mortality particularly in low and middle-income countries. Environmental tobacco smoke (ETS) exposure is a recognised risk factor for both acute and chronic respiratory illness.

Areas covered: The aim of this paper was to review the epidemiology of ETS exposure and impact on respiratory health in children. We conducted a search of 3 electronic databases of publications on ETS and childhood respiratory illness from 1990–2015. Key findings were that up to 70% of children are exposed to ETS globally, but under-reporting may mask the true prevalence. Maternal smoking and ETS exposure influence infant lung development and are associated with childhood upper and lower respiratory tract infection, wheezing or asthma. Further, exposure to ETS is associated with more severe respiratory disease. ETS exposure reduces lung function early in life, establishing an increased lifelong risk of poor lung health.

Expert commentary: Urgent and effective strategies are needed to decrease ETS exposure in young children to improve child and long-term lung health in adults especially in low and middle income countries where ETS exposure is increasing.

KEYWORDS:

• Cigarette smoking
• environmental tobacco smoke
• child lung health

Declaration of interest

A. Vanker is a PhD student who has received funding from the following sources: Discovery Foundation, South African Thoracic Society AstraZeneca Respiratory Fellowship, National Research Fund, South Africa, CIDRI Clinical Fellowship, Medical Research Council, South Africa, Bill & Melinda Gates Foundation (OPP1,017,641). H.J Zar has received funding for the Drakenstein study from the Bill and Melinda Gates Foundation [OPP 1017641]; from the National Institutes of Health (NIH U01AI110466-01A1), MRC South Africa, The National Research Foundation, South Africa. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.